Update From the Athletic Trainers Section

1. Update From the Athletic Trainers Section Ohio Occupational Therapy, Physical Therapy, and Athletic Trainers Board

2. Topics • Ohio Licensure Requirement • Recent/Upcoming Rules Changes • Other Common Questions/Issues Ohio OTPTAT Board

3. Ohio Licensure Requirement Per ORC 4755.62 (A): • No person shall claim to the public to be an athletic trainer or imply by words, actions, or letters that the person is an athletic trainer unless the person is licensed as an athletic trainer, or otherwise engage in the practice of athletic training. Ohio OTPTAT Board

4. What Does ORC 4755.62 Mean? • Unlicensed persons cannot: • Refer to themselves as an “athletic trainer” • Represent themselves as an “athletic trainer” • Engage in the practice of athletic training • These restrictions apply to individuals licensed/certified as ATs in another state but not currently licensed in Ohio • There is no grace period that allows a certified AT to work pending the Ohio license Ohio OTPTAT Board

5. Licensure vs. Certification • It is illegal to practice as an AT in Ohio without valid Ohio license • The Ohio license must be issued prior to practicing athletic training in Ohio • BOC certification alone does not authorize an athletic trainer to practice in Ohio Ohio OTPTAT Board

6. Approval of an Event • Based on change made in HB 403 • Allows ATs not tied to a traveling team to temporarily provide services w/o Ohio license. • Non-Ohio licensed services may only be provided at an event approved by the AT Section. • Ex: U.S. Track and Field Championships • Not: AT from LSU traveling with and providing services to the AT’s visiting athletes. Ohio OTPTAT Board

7. Approval of an Event OAC 4755-43-11 • Organizer of an event at which non-Ohio licensed ATs will provide athletic training services must apply to AT Section for approval of the event • Approval form on Board’s website Ohio OTPTAT Board

8. Exemptions from Licensure • Exemptions specified in ORC 4755.65 • Non-Ohio licensed AT traveling with visiting team/organization for purpose of only providing athletic training to the visiting team/organization • Providing services at an approved AT event • Students in CAATE programs completing clinical education requirements Ohio OTPTAT Board

9. How Rules Are Changed • Rule review is a public process. • Board seeks input on initial draft before rule language is filed. • Information on proposed changes sent to listserv and posted on the Board’s website. • Once filed, full text of the rules is available at: http://www.registerofohio.state.oh.us • Public hearing on proposed changes required. • Board’s goal is new rules go into effect on May 1. Ohio OTPTAT Board

10. Substantive 2009-10 Rules Changes • 4755-41-01 - Code of Ethical Conduct • Added provisions related to verbal and sexual harassment • Reworded informed consent language • Reworded prohibition on practicing while impaired by drugs, alcohol, and/or physical/mental disability • Added provisions dealing with billing and other conflicts of interest • Added requirement for licensees to report to Board any illegal/unethical practice by other licensees Ohio OTPTAT Board

11. Substantive 2009-10 Rules Changes • 4755-45-01 - Continuing Education • Reduce amount needed from 50 hours to 25 hours • Makes appropriate adjustments to category limits • Grants credit for NATA accredited post-professional AT education program • Eliminates credit for CPR/First Aid • Still requires at least 1 hours of ethics each renewal • Eliminate category limits for postgraduate coursework CE category Ohio OTPTAT Board

12. Substantive 2009-10 Rules Changes • 4755-43-06 – License Reinstatement • Alters the CE requirement for reinstatement • Any reinstatement apps submitted w/in 1 month of expiration • Amt of CE needed to renew = amt for reinstatement • 4755-43-10 – Reconsideration of Revoked or Denied License • Specifies parameters used by Section when reviewing licensure application from revoked or denied license applicant Ohio OTPTAT Board

13. Pocket ID Cards • Amendments to rules 4755-44-02 & 4755-47-01 – elimination of pocket ID cards • As of May 1, 2010, the Board will no longer issue pocket ID cards • Recent increase in # of doctored ID cards • Enhancement of currency of information on, and acceptance of, online license verification • Rule 4755-44-02 will require licensees to have available current license information from Ohio e-License Center (https://license.ohio.gov/lookup) • Availability can be printed page, smartphone access, client’s home computer, etc. Ohio OTPTAT Board

14. Renewal Cycle Change • All AT’s will renew in even-numbered years. • New expiration date… September 30. • If you last renewed on 5/15/08. • Renewed thru 9/30/10. Will pay $80 in 2010. Do 25 hrs of CE between 5/16/08 and 9/30/10. • If you last renewed on 5/15/09. • Renewed thru 9/30/10. Will pay $40 in 2010. Do 12 hrs of CE between 5/16/09 and 9/30/10. • Licensees will get 4 free months due to change. Ohio OTPTAT Board

15. Things To Keep In Mind…. • After you renew your license, verify your expiration date online prior to practicing after your expiration date. • As healthcare professionals, you have an ethical obligation to report any behavior you believe is unethical and/or illegal. • Disciplinary actions are public record and are permanent; be aware of your practice act and any changes that occur over the years. Ohio OTPTAT Board

16. Other Common Questions/ Issues • OTPTAT v. BOC v. OATA? • What is the mission of the AT Section? • Is there a licensure grace period? • Can AT’s bill For services? • Will I be subjected to a criminal records check? • What is the role of the team physician? • Standard Operating Procedures? Ohio OTPTAT Board

17. Other Common Questions/ Issues • What is the role of the AT for visiting teams • Injury, RTP, pre-game taping/treatments, documentation • What is the role of the coach in taping injuries • What happens when a team arrives and needs athletes taped, but has no referral from their AT or physician – can we legally tape them? • Role of AT’s in Clinic Ohio OTPTAT Board

18. OTPTAT v. BOC v. OATAThe Alphabet Soup of the Profession • OTPTAT is your state regulatory agency. It licenses individuals and enforces the practice act. • BOC is a certification entity. Certification allows a practitioner to use the credentials ATC. It is not mandatory that you hold certification. • OATA is the state professional association. Along with the NATA, it advocates on the state/federal level for the profession. Ohio OTPTAT Board

19. Mission of the AT Section The Mission of the AT Section is to Protect the Public, NOT the Licensee Ohio OTPTAT Board

20. Licensure Grace Period • There is NO licensure grace period. • Between graduation and receiving a license, a new graduate is an UNLICENSED SUPPORT PERSON. • Individuals licensed as AT’s in a state other than Ohio can only work as unlicensed support personnel until the Board issues an Ohio AT license. • Help keep prospective licensees out of trouble! Ohio OTPTAT Board

21. Criminal Records Checks • HB 104 requires the Board to receive results of FBI and BCI records checks before issuing license. • Only applies for initial applications. • Not a requirement for license renewal. • Ink rolled fingerprints for out of state applicants can take 3-4 months. • Be aware of this time frame if you’re hiring from out of state. • No license issued until Board receives the criminal records check results. Ohio OTPTAT Board

22. Role of the Team Physician • Referral relationship must exist between AT and team physician for care of that team’s athletes. • Revised Code section 4755.60 and Administrative Code rule 4755-42-02. • ATs employed by colleges, universities, high schools, other scholastic institutions, and professional organizations/clubs function under this referral relationship. Ohio OTPTAT Board

23. Role of the Team Physician • This relationship should consist of: • A protocol of care communicated between the team physician and the athletic trainer • This relationship should include procedures for: • Prevention, recognition, assessment, management, treatment, disposition, and reconditioning of athletic injuries. Ohio OTPTAT Board

24. Role of the Team Physician • A referral relationship between a team physician and an athletic trainer requires interaction by both parties. • In general practice, athletic trainers administer first aid and team physicians initiate referrals for continued treatment. • This relationship is maintained by on-going verbal and written communication. Ohio OTPTAT Board

25. Standard Operating Procedures • AT’s professional responsibility to have written policies and procedures. • AT’s encouraged to review current policies and procedures with their employers to determine if the existing policies are within the scope of athletic training practice. • AT Section has no guidelines re: policy and procedure content. • AT Section does advocate that all AT’s have written policies and procedures to guide the day-to-day operations of athletic training care. Ohio OTPTAT Board

26. Standard Operating Procedures • If no athletic training policies and procedures exist, please establish them and put them in writing. • Standard operating policies and procedures should be reviewed and approved by a team physician or an organization’s medical director. Ohio OTPTAT Board

27. The Three Types of Treatment • First Aid – basic, immediate care given on site to stabilize & prepare for evacuation and referral, as needed. • Routine – maintenance & preventative measurers commonly used by ATs (e.g.: pre-event warm-ups) • Intent of routine treatment is maintenance of normal function during participation • Restorative – patient specific instructions for use with diagnosed injury or as prescribed by referral source Ohio OTPTAT Board

28. The Three Types of Treatment • Referral NOT required for: • First aid treatment • Routine treatment • Referral REQUIRED for: • Restorative treatment Ohio OTPTAT Board

29. Role of the AT for Visiting Teams • Athletic trainers may provide visiting teams, traveling without an athletic trainer or a team physician, with first aid and emergency coverage only. • They should not provide treatments without an appropriate referral or make return to participation decisions for visiting athletes. Ohio OTPTAT Board

30. Role of the Coach in Taping Injuries • Taping an athlete can be accomplished by many different individuals, such as athletic trainers, physical therapists, physicians, coaches, and even other athletes. • Athletes sometimes request to be taped by a prophylactic measure or as a ritual for participation. • Prophylactic taping is not care of an injury • It does not call for the degree of skill in selection of taping method or application, as might be used by a licensed health care practitioner. Ohio OTPTAT Board

31. Role of the Coach in Taping Injuries • Why an individual is being taped is determining factor in deciding who is permitted to tape an athlete. • If a taping or strapping/wrapping procedure or application is necessary as part of a regime of the care of an injury, this is only to be done by a licensed health care practitioner. • With increasing the standards of care for athletes, there are situations that call for taping as care of an injury, as required to participate, as determined by a referral source. Such a directive or prescribed method of care should only be applied by a licensed health care practitioner. Ohio OTPTAT Board

32. How may an AT function in the Clinic Setting? • Under an AT Referral from an accepted practitioner, the AT functions independently and is responsible for documentation • Provide athletic training services (evaluation and treatment) based upon physician referral Ohio OTPTAT Board

33. How may an AT function in the Clinic Setting? • Under a PT Referral, the athletic trainer functions as “Other Licensed Personnel” • AT cannot be assigned own physical therapy caseload without supervising PT having direct contact with each patient each visit. • Under a PT referral, “Other Licensed Personnel” have limits on making adjustments to the established plan of care Ohio OTPTAT Board

34. Billing For Services • Billing is not within the Board’s jurisdiction, unless billing fraud is suspected. • Nothing in the practice act prevents AT’s from billing for services. • Contact the OATA, or the NATA, or refer to the CPT codes listed under physical medicine for billing advice. Ohio OTPTAT Board

35. Billing, Medicare and BWC • The Board has no jurisdiction over billing/Medicare/BWC matters, unless fraud is suspected. • The Board cannot assist in clarification of Medicare/BWC issues. • The Board does not give billing advice. Ohio OTPTAT Board

36. Change of Address • Ohio law requires all licensees to notify the Board, in writing, of a change of address within THIRTY days of the change. • Failure to notify the Board, could result in the delay of the processing of your renewal application. Ohio OTPTAT Board

37. Listserv • Used to notify licensees & interest parties of: • Website changes • Public hearings • Laws/Rules changes • Timely and Cost-effective • To join, send an email to: board@otptat.ohio.gov • Or go to http://otptat.ohio.gov and select “Join a Board Listserv” link on the homepage Ohio OTPTAT Board

38. Board Composition – AT Section Ohio OTPTAT Board

39. Board Composition • The Board also has a public member who represents the interests of consumers. • Genevieve Dennison – New Richmond. 1st term expires in 2011 • To seek an appointment to the Board, you need to contact the Governor’s Office and download the application. http://governor.ohio.gov Ohio OTPTAT Board

40. Contacting the Board • Email: board@otptat.ohio.gov • Internet: http://otptat.ohio.gov • Phone: 614-466-3774 • Fax: 614-995-0816 • Mail: Ohio OTPTAT Board 77 S. High Street, 16th Floor Columbus, OH 43215-6108 Ohio OTPTAT Board